Also known as an autologous (own tissue) reconstruction, the DIEP Flap procedure is a form of breast reconstruction surgery where skin, fat and blood vessels are removed from the wall of a woman’s lower belly and used to reconstruct the breast following a mastectomy. The procedure is ‘muscle sparing’ which means the surgeon will not move or cut any muscles, resulting in an overall shorter recovery time. ‘DIEP’ stands for Deep Inferior Epigastric Perforator, which are the branches of the blood vessels that are relocated during the procedure.
The main difference between a DIEP Flap and a breast implant is that the results should be life-long with revision surgery rarely being required. As the abdominal muscle is kept intact there are few long-term complications from the procedure. Also, the reconstructed breast should age naturally and change as an individual’s body weight changes.
When is it recommended?
A DIEP Flap is a good option for women looking for an alternative to breast implants, but best candidates need to have enough tissue around their belly to reconstruct the breast to their desired size. The DIEP Flap is not recommended for women who are especially thin, or those who need to return to daily activities quickly. When considering the DIEP Flap procedure, body type, health, lifestyle, and personal reconstruction goals should all be taken into account. It is crucial to consider all options and discuss these with a Breast Consultant. The DIEP Flap can be done at the time of a mastectomy, months later, or even years later.
What happens during the procedure?
During the DIEP Flap procedure the surgeon will first make a circular incision around the nipple. They will then remove the breast from the inside, allowing the breast skin to remain intact.
As the Mastectomy phase of the procedure is completed, an incision is then made in the patient’s lower abdomen. Here the surgeon will remove a section of skin, fatty tissue and blood vessels (the flap). Using a microscope, the surgeon will then connect the blood vessels in the flap to the vessels in the chest. Once the desired volume of tissue is connected, it is trimmed to size and the skin removed (apart from a small circle that will take the place of the removed nipple).
After the breast surgeon has manoeuvred the flap into the breast pocket through the original incision, a plastic surgeon will then shape the breast and close the cut in the tummy. While the length of the procedure depends on whether a Mastectomy is carried out at the same time, it can often take eight to twelve hours to complete.
The recovery
Following surgery, patients who have undergone the DIEP Flap procedure will need to remain in hospital under close observation for two to four days. On average patients go home on the third post-operative day. During this time, the surgical team will monitor blood flow to the newly constructed breast. Our surgeons have pioneered the ‘drainless DIEP technique’, where drains are not used in the tummy. This speeds up recovery and reduces pain and complications. If drains have been used during surgery, then on the whole, these are removed before leaving hospital. Most patients have recovered back to normal daily activities after 6 weeks, but a complete recovery can take up to 3 months.
At New Victoria Hospital, our renowned Breast Surgeons specialise in administering the DIEP Flap procedure. Our Breast Team ensures every patient receives the highest level of care throughout their stay at our hospital.
